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59 results on '"Burra, Patrizia"'

1. Hepatic encephalopathy increases the risk for mortality and hospital readmission in decompensated cirrhotic patients: a prospective multicenter study

Author

Riggio, Oliviero, Celsa, Ciro, Calvaruso, Vincenza, Merli, Manuela, Caraceni, Paolo, Montagnese, Sara, Mora, Vincenzina, Milana, Martina, Saracco, Giorgio Maria, Raimondo, Giovanni, Benedetti, Antonio, Burra, Patrizia, Sacco, Rodolfo, Persico, Marcello, Schepis, Filippo, Villa, Erica, Colecchia, Antonio, Fagiuoli, Stefano, Pirisi, Mario, Barone, Michele, Azzaroli, Francesco, Soardo, Giorgio, Russello, Maurizio, Morisco, Filomena, Labanca, Sara, Fracanzani, Anna Ludovica, Pietrangelo, Antonello, Di Maria, Gabriele, Nardelli, Silvia, Ridola, Lorenzo, Gasbarrini, Antonio, and Cammà, Calogero

Subjects
hospital readmission, hepatic encephalopathy, Settore MED/09 - MEDICINA INTERNA, General Medicine, orthotopic liver transplant, mortality, decompensated cirrhosis
Abstract

IntroductionHepatic encephalopathy (HE) affects the survival and quality of life of patients with cirrhosis. However, longitudinal data on the clinical course after hospitalization for HE are lacking. The aim was to estimate mortality and risk for hospital readmission of cirrhotic patients hospitalized for HE.MethodsWe prospectively enrolled 112 consecutive cirrhotic patients hospitalized for HE (HE group) at 25 Italian referral centers. A cohort of 256 patients hospitalized for decompensated cirrhosis without HE served as controls (no HE group). After hospitalization for HE, patients were followed-up for 12 months until death or liver transplant (LT).ResultsDuring follow-up, 34 patients (30.4%) died and 15 patients (13.4%) underwent LT in the HE group, while 60 patients (23.4%) died and 50 patients (19.5%) underwent LT in the no HE group. In the whole cohort, age (HR 1.03, 95% CI 1.01–1.06), HE (HR 1.67, 95% CI 1.08–2.56), ascites (HR 2.56, 95% CI 1.55–4.23), and sodium levels (HR 0.94, 95% CI 0.90–0.99) were significant risk factors for mortality. In the HE group, ascites (HR 5.07, 95% CI 1.39–18.49) and BMI (HR 0.86, 95% CI 0.75–0.98) were risk factors for mortality, and HE recurrence was the first cause of hospital readmission.ConclusionIn patients hospitalized for decompensated cirrhosis, HE is an independent risk factor for mortality and the most common cause of hospital readmission compared with other decompensation events. Patients hospitalized for HE should be evaluated as candidates for LT.

Published
2023

2. Using machine learning to predict antibody response to SARS-CoV-2 vaccination in solid organ transplant recipients: the multicentre ORCHESTRA cohort

Author

Giannella, Maddalena, Huth, Manuel, Righi, Elda, Hasenauer, Jan, Marconi, Lorenzo, Konnova, Angelina, Gupta, Akshita, Hotterbeekx, An, Berkell, Matilda, Palacios-Baena, Zaira R, Morelli, Maria Cristina, Tamè, Mariarosa, Busutti, Marco, Potena, Luciano, Salvaterra, Elena, Feltrin, Giuseppe, Gerosa, Gino, Furian, Lucrezia, Burra, Patrizia, Piano, Salvatore, Cillo, Umberto, Cananzi, Mara, Loy, Monica, Zaza, Gianluigi, Onorati, Francesco, Carraro, Amedeo, Gastaldon, Fiorella, Nordio, Maurizio, Kumar-Singh, Samir, Baño, Jesús Rodríguez, Lazzarotto, Tiziana, Viale, Pierluigi, Tacconelli, Evelina, and Tessari, Chiara

Subjects
Microbiology (medical), SARS-CoV-2 vaccination, solid organ transplant, antibody response, SARS-CoV-2 vaccination, Infectious Diseases, solid organ transplant, antibody response, General Medicine
Published
2023

3. The role of preoperative optimization of the nutritional status on the improvement of short‐term outcomes after liver transplantation? A review of the literature and expert panel recommendations

Author

Victor, David W, Zanetto, Alberto, Montano-Loza, Aldo J, Heimbach, Julie K, Towey, Jennifer, Spiro, Michael, Raptis, Dimitri Aristotle, and Burra, Patrizia

Subjects
liver transplant, Transplantation, iron deficiency, vitamin D, malnutrition, optimization
Abstract

Malnutrition is a known risk factor for postoperative morbidity and mortality in patients awaiting liver transplantation (LT). Malnutrition is a potentially reversible risk factor, though there are no clear guidelines on the best mechanism for an improvement. It also remains unclear if preoperative nutritional interventions have benefits to post-transplant outcomes for transplant recipients.Primary objective: To identify if preoperative optimization of nutritional status is associated with improved short-term outcomes after LT.To determine if preoperative improvement of malnutrition improves short-term outcomes after LT, as well as, if weight loss in obese patients affects short-term outcomes after LT.Ovid MEDLINE, Embase, Scopus, Google Scholar, and Cochrane Central.Systematic review following PRISMA guidelines and recommendations using the GRADE approach derived from an international expert panel. POSPERO Protocol ID: CRD42021237450 RESULTS: 3851 records were identified in searching the databases, 3843 records were excluded by not fulfilling eligibility criteria. Seven full-text articles were included for the final analysis of which three were randomized controlled trials, one was prospective observational studies, and three were retrospective observational studies. No appreciable difference in mortality, post-transplant complication rate was noted across the studies. Length of stay (LOS) was noted to be shorter in two observational studies of Vitamin D deficiency in liver transplant patients.We have made a weak recommendation supporting pre-transplant nutritional supplementation due to possible benefit in reducing LOS as well as the lack of harms (Quality of Evidence low | Grade of Recommendation; Weak). No effective conclusions were reached for the secondary objectives due to the conflicting evidence. This article is protected by copyright. All rights reserved.

Published
2022

4. HCC recurrence in HCV‐infected patients after liver transplantation: SiLVER Study reveals benefits of sirolimus in combination with CNIs – a post‐hoc analysis

Author

Werner, Jens M., Hornung, Matthias, Krah, Rubertha, Götz, Markus, Schnitzbauer, Andreas A., Schlitt, Hans J., Geissler, Edward K., Zülke, Carl, Lamby, Philipp E., Proneth, Andrea, Duvoux, Christophe, Burra, Patrizia, Jauch, Karl‐Walter, Rentsch, Markus, Ganten, Tom M., Schmidt, Jan, Settmacher, Utz, Heise, Michael, Rossi, Giorgio, Cillo, Umberto, Kneteman, Norman, Adam, René, Hoek, Bart, Bachellier, Philippe, Wolf, Philippe, Rostaing, Lionel, Bechstein, Wolf O., Rizell, Magnus, Powell, James, Hidalgo, Ernest, Gugenheim, Jean, Wolters, Heiner, Brockmann, Jens, Roy, André, Mutzbauer, Ingrid, Schlitt, Angela, Beckebaum, Susanne, Graeb, Christian, Nadalin, Silvio, Valente, Umberto, Turrión, Victor Sánchez, Jamieson, Neville, Scholz, Tim, Colledan, Michele, Fändrich, Fred, Becker, Thomas, Söderdahl, Gunnar, Chazouillères, Olivier, Mäkisalo, Heikki, Pageaux, Georges‐Philippe, Steininger, Rudolf, Soliman, Thomas, Jong, Koert P., Pirenne, Jacques, Margreiter, Raimund, Pratschke, Johann, Pinna, Antonio D., Hauss, Johann, Schreiber, Stefan, Strasser, Simone, Klempnauer, Jürgen, Troisi, Roberto I., Bhoori, Sherrie, Lerut, Jan, Bilbao, Itxarone, Klein, Christian G., Königsrainer, Alfred, Otto, Gerd, Mazzaferro, Vincenzo, Neuhaus, Peter, Werner, J, Hornung, M, Krah, R, Gotz, M, Schnitzbauer, A, Schlitt, H, Geissler, E, Zulke, C, Lamby, P, Proneth, A, Duvoux, C, Burra, P, Jauch, K, Rentsch, M, Ganten, T, Schmidt, J, Settmacher, U, Heise, M, Rossi, G, Cillo, U, Kneteman, N, Adam, R, Hoek, B, Bachellier, P, Wolf, P, Rostaing, L, Bechstein, W, Rizell, M, Powell, J, Hidalgo, E, Gugenheim, J, Wolters, H, Brockmann, J, Roy, A, Mutzbauer, I, Schlitt, A, Beckebaum, S, Graeb, C, Nadalin, S, Valente, U, Turrion, V, Jamieson, N, Scholz, T, Colledan, M, Fandrich, F, Becker, T, Soderdahl, G, Chazouilleres, O, Makisalo, H, Pageaux, G, Steininger, R, Soliman, T, Jong, K, Pirenne, J, Margreiter, R, Pratschke, J, Pinna, A, Hauss, J, Schreiber, S, Strasser, S, Klempnauer, J, Troisi, R, Bhoori, S, Lerut, J, Bilbao, I, Klein, C, Konigsrainer, A, Otto, G, Mazzaferro, V, and Neuhaus, P

Subjects
Silver Study, medicine.medical_specialty, Carcinoma, Hepatocellular, Silver, direct-acting antiviral agents, medicine.medical_treatment, 610 Medizin, Subgroup analysis, 030230 surgery, Liver transplantation, Gastroenterology, Group B, 03 medical and health sciences, HEPATOCELLULAR-CARCINOMA, hepatitis C virus infection, hepatocellular carcinoma, liver transplantation, 0302 clinical medicine, Internal medicine, Post-hoc analysis, medicine, Humans, Sirolimus, direct-acting antiviral agent, ddc:610, Transplantation, business.industry, Liver Neoplasms, Immunosuppression, medicine.disease, Hepatitis C, digestive system diseases, Calcineurin, Hepatocellular carcinoma, 030211 gastroenterology & hepatology, Neoplasm Recurrence, Local, business, medicine.drug
Abstract

Factors affecting outcomes in liver transplant (LTx) recipients with hepatocellular carcinoma (HCC) and hepatitis C viral (HCV) infection include the choice of immunosuppression. Here, we analyzed the HCV+ subgroup of patients from the randomized controlled, international SiLVER Study. We performed a post hoc analysis of 166 HCV+ SiLVER Study patients regarding HCC outcome after LTx. Control patients (group A: n=88) received mTOR inhibitor (mTORi)-free, calcineurin inhibitor (CNI)-based versus sirolimus-based immunosuppression (group B: n=78). We found no significant difference regarding HCV-RNA titers between group A and B. Since no effect in group B could be due to variable sirolimus dosing, we split group B into patients receiving sirolimus-based immunosuppression+CNIs for >50% (B1; n=44) or

Published
2020

5. Lean non-alcoholic fatty liver disease patients from the global NASH registry

Author

Younossi, Zobair, Yusuf Yilmaz, Yu, Ming-Lung, Wong, Vincent Wai-Sun, Castellanos-Fernandez, Marlen, Isakov, Vasily, Duseja, Ajay Kumar, Mendez-Sanchez, Nahum, Eguchi, Yuichiro, Bugianesi, Elisabetta, Burra, Patrizia, George, Jacob, Fan, Jian-Gao, Papatheodoridis, George, Chan, Wah-Kheong, Alswat, Khalid, Hamid, Saeed Sadiq, Singal, Ashwani, Gomez, Manuel Romero, Gordon, Stuart C., Roberts, Stuart, El Kassas, Mohamed, Kugelmas, Marcelo, Ong, Janus, Alqahtani, Saleh, Ziayee, Mariam, Lam, Brian, Younossi, Issah, Racila, Andrei, Henry, Linda, and Stepanova, Maria

Subjects
Hepatology
Published
2022

6. Effect of direct-acting antivirals on future occurrence of hepatocellular carcinoma in compensated cirrhotic patients

Author

Cucchetti, Alessandro, D’Amico, Gennaro, Trevisani, Franco, Morelli, Maria Cristina, Vitale, Alessandro, Pinna, Antonio Daniele, Cescon, Matteo, Cillo, Umberto, Burra, Patrizia, Russo, Francesco P., Mescoli, Claudia, Rendina, Maria, Lupo, Luigi G., Losito, Francesco, Fucilli, Fabio, Brancaccio, Giusep-Pina, Persico, Marcello, Viganò, Luca, Iavarone, Massimo, D’Ambrosio, Roberta, Sangiovanni, Angelo, Renzulli, Matteo, Galati, Giovanni, Ponziani, Francesca Romana, Pompili, Maurizio, Miele, Luca, Grieco, Antonio, Rapaccini, Gianlodovico, Gasbarrini, Antonio, Sandri, Giovanni Battisa Levi, Lai, Quirino, Melandro, Fabio, Rossi, Massimo, Lenci, Ilaria, Manzia, Tommaso Maria, Tortora, Raffaella, Di Costanzo, Giovan Giuseppe, Sacco, Rodolfo, Simonetti, Natalia, Morisco, Filomena, Guarino, Maria, Cabibbo, Giuseppe, Bhoori, Carlo Sposito Sherrie, Di Sandro, Stefano, Foschi, Francesco Giuseppe, Gardini, Andrea Casadei, Nicolini, Daniele, Mazzocato, Susanna, Alba, Kostandini, Violi, Paola, Baccarani, Umberto, Pravisani, Riccardo, A. Cucchetti, G. D'Amico, F. Trevisani, M.C. Morelli, A. Vitale, A.D.Pinna, M. Cescon, Cucchetti, Alessandro, D’Amico, Gennaro, Trevisani, Franco, Morelli, Maria Cristina, Vitale, Alessandro, Pinna, Antonio Daniele, Cescon, Matteo, Cillo, Umberto, Burra, Patrizia, Russo, Francesco P., Mescoli, Claudia, Rendina, Maria, Lupo, Luigi G., Losito, Francesco, Fucilli, Fabio, Brancaccio, Giusep-Pina, Persico, Marcello, Viganò, Luca, Iavarone, Massimo, D’Ambrosio, Roberta, Sangiovanni, Angelo, Renzulli, Matteo, Galati, Giovanni, Ponziani, Francesca Romana, Pompili, Maurizio, Miele, Luca, Grieco, Antonio, Rapaccini, Gianlodovico, Gasbarrini, Antonio, Sandri, Giovanni Battisa Levi, Lai, Quirino, Melandro, Fabio, Rossi, Massimo, Lenci, Ilaria, Manzia, Tommaso Maria, Tortora, Raffaella, Di Costanzo, Giovan Giuseppe, Sacco, Rodolfo, Simonetti, Natalia, Morisco, Filomena, Guarino, Maria, Cabibbo, Giuseppe, Bhoori, Carlo Sposito Sherrie, Di Sandro, Stefano, Foschi, Francesco Giuseppe, Gardini, Andrea Casadei, Nicolini, Daniele, Mazzocato, Susanna, Alba, Kostandini, Violi, Paola, Baccarani, Umberto, and Pravisani, Riccardo

Subjects
Male, Time Factors, Sustained Virologic Response, Hepatocellular carcinoma, Hepacivirus, Direct-acting antiviral, Direct-acting antivirals, medicine.disease_cause, Gastroenterology, Competing risk, Hepatitis C, Markov model, Survival benefit, Sustained virological response, Hepatology, 0302 clinical medicine, Risk Factors, 030212 general & internal medicine, biology, Incidence, Incidence (epidemiology), Liver Neoplasms, Middle Aged, Markov Chains, Competing risk Direct-acting antivirals Hepatitis C Hepatocellular carcinoma Markov model Survival benefit Sustained virological response, Italy, Liver Neoplasm, Female, 030211 gastroenterology & hepatology, Human, Adult, medicine.medical_specialty, Carcinoma, Hepatocellular, Time Factor, Hepatitis C virus, Antiviral Agents, 03 medical and health sciences, Internal medicine, medicine, Humans, Antiviral Agent, Hepaciviru, business.industry, Risk Factor, Carcinoma, Hepatocellular, Markov Chain, medicine.disease, biology.organism_classification, digestive system diseases, Settore MED/18 - Chirurgia Generale, Liver function, Varices, business
Abstract

Background: The achievement of high rates of sustained virological response (SVR) with direct-acting antivirals (DAAs) in hepatitis C virus (HCV) infected patients will reduce decompensating terminal events. Aims: To investigate whether hepatocellular carcinoma (HCC) occurrence could change due to the DAA-induced increase in life-expectancy. Methods: A Markov model was built on clinical data of 494 cirrhotic patients and available literature to estimate probabilities of “death before HCC” and of “HCC occurrence” without and with DAA. Results: In comparison to untreated patients, DAA therapy reduced the 20-year mortality before HCC by 21.9% in patients without varices and by 21.5% in those with varices, considering an SVR of 95% and no direct effect on hepatocarcinogenesis. Tumour occurrence increased by 5%–8.2% and the proportion of HCCs diagnosed in compensated stages increased to >98%. If we consider DAA as having “anti-tumoral” effects, the benefit becomes greater, achieving a 20-year survival of 81.5% in patients without varices, and 52.2% in patients with varices. Instead, if we consider DAA as having a “pro-tumoral” effect, then, the increased incidence of HCC nullifies the survival benefits. Conclusion: DAAs drastically reduce the mortality caused by the liver function worsening, increasing the proportion of HCCs diagnosed in compensated stages. Knowledge of the DAA effect on hepatocarcinogenesis remains pivotal. © 2017 Editrice Gastroenterologica Italiana S.r.l.

Published
2018

7. Recommendations for liver transplantation for hepatocellular carcinoma: an international consensus conference report

Author

Clavien, Pa, Lesurtel, M, Bossuyt, Pm, Gores, Gj, Langer, B, Perrier, A, OLT for HCC Consensus Group Abecassis, M, Balabaud, C, Barritt, Gj, Belghiti, J, Bhoori, S, Bossuyt, P, Breitenstein, S, Broelsch, C, Bruix, J, Burra, Patrizia, Burroughs, A, Busuttil, R, Charlton, M, Cherqui, D, Colombo, Ml, D'Albuquerque, C, D'Alessandro, A, de Santibañez EJ, Dufour, F, Durand, F, Dutkowski, P, Duvoux, C, El Serag, H, Fan, St, Finn, Rs, Fisher, R, Forner, A, Freeman, R, Fung, J, Geier, A, Germani, G, Gores, G, Gouw, As, Grant, D, Greig, P, Gurusamy, K, Hanto, D, Heaton, N, Heim, M, Hemming, A, Hippen, B, Hisham, A, Hubscher, S, Ichida, T, Kahn, D, Kew, M, Kita, Y, Kiuchi, T, Klintmalm, Gb, Kneteman, N, Kojiro, M, Kudo, M, Lee, Jm, Lee, Sg, Lencioni, R, Lerut, J, Livraghi, T, Llovet, J, Lo, Cm, Lodge, P, Maccaughan, G, Madoff, D, Majno, P, Marcellin, P, Marrero, J, Mazzaferro, V, Mergental, H, Merle, P, Miksad, R, Mornex, F, Müllhaupt, B, Olthoff, K, Paradis, V, Pestalozzi, B, Pomfret, E, Poon, R, Porte, R, Prasad, Kr, Raptis, D, Roskams, T, Rossi, M, Samuel, D, Schlitt, H, Schwartz, M, Sexton Dobby AM, Shaked, A, Sherman, M, Siegler, M, Suh, Ks, Todo, S, Toso, C, Trevisani, F, Trotter, Jj, Valdecasas, Gj, Vauthey, N, Vilgrain, V, Villamil, F, Vonlanthen, R, Wald, C, Weber, A, Wiesner, R, Wright, L, Yao, F, Zheng, Ss, Zucman Rossi, J., P.A.Clavien, M. Lesurtel, P.M. Bossuyt, G.J. Gore, B. Langer, A. Perrier, on behalf of the OLT for HCC Consensus Group […, F. Trevisani, and …]

Subjects
medicine.medical_specialty, Carcinoma, Hepatocellular, Waiting Lists, medicine.medical_treatment, media_common.quotation_subject, MEDLINE, 030230 surgery, Liver transplantation, Milan criteria, Risk Assessment, Article, RECOMMENDATIONS, 03 medical and health sciences, 0302 clinical medicine, Jury, Risk Factors, Liver Neoplasms/mortality/surgery, medicine, hepatocellular carcinoma, liver transplantation, Humans, HEPATOCELLULAR CARCINOMA, Hepatocellular/mortality/surgery, Tissue Donors/supply & distribution, media_common, ddc:616, Evidence-Based Medicine, business.industry, Patient Selection, Liver Neoplasms, Carcinoma, LIVER TRANSPLANTATION, Evidence-based medicine, medicine.disease, Tissue Donors, Neoadjuvant Therapy, 3. Good health, Surgery, Treatment Outcome, Oncology, Family medicine, Donation, Hepatocellular carcinoma, Liver Transplantation/adverse effects/mortality/standards, 030211 gastroenterology & hepatology, Working group, business
Abstract

Although liver transplantation is a widely accepted treatment for hepatocellular carcinoma (HCC), much controversy remains and there is no generally accepted set of guidelines. An international consensus conference was held on Dec 2–4, 2010, in Zurich, Switzerland, with the aim of reviewing current practice regarding liver transplantation in patients with HCC and to develop internationally accepted statements and guidelines. The format of the conference was based on the Danish model. 19 working groups of experts prepared evidence-based reviews according to the Oxford classification, and drafted recommendations answering 19 specific questions. An independent jury of nine members was appointed to review these submissions and make final recommendations, after debates with the experts and audience at the conference. This report presents the final 37 statements and recommendations, covering assessment of candidates for liver transplantation, criteria for listing in cirrhotic and non-cirrhotic patients, role of tumour downstaging, management of patients on the waiting list, role of living donation, and post-transplant management.

Published
2012
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8. Skin Cancer and Other Cutaneous Disorders in Liver Transplant Recipients

Author

Belloni Fortina, A, Piaserico, Stefano, Bordignon, M, Gambato, M, Senzolo, M, Russo, FRANCESCO PAOLO, PESERICO STECCHINI NEGRI DE SALVI, Andrea, De Matteis, G, Perissinotto, Egle, Cillo, Umberto, Vitale, A, Alaibac, MAURO SALVATORE ALESSANDRO, Burra, Patrizia, and BELLONI FORTINA, Anna

Subjects
Adult, medicine.medical_specialty, Skin Neoplasms, Time Factors, medicine.medical_treatment, Population, Kaplan-Meier Estimate, Dermatology, Risk Assessment, Skin Diseases, Gastroenterology, Pharmacotherapy, Risk Factors, Internal medicine, medicine, Humans, education, education.field_of_study, Chi-Square Distribution, business.industry, Incidence, Incidence (epidemiology), Age Factors, Immunosuppression, General Medicine, Middle Aged, medicine.disease, Liver Transplantation, Transplantation, Regimen, Logistic Models, Italy, Multivariate Analysis, Sunlight, Drug Therapy, Combination, Skin cancer, business, Risk assessment, Immunosuppressive Agents
Abstract

Patients who have received liver transplant are at increased risk of skin complications due to long-term immunosuppression regimen. The aim of this study was to analyze the incidence and risk factors of skin complications in liver transplant patients. We analyzed 161 liver transplant recipients. The mean age at transplantation was 47.4 years. Mean follow-up was 6 years. Seventy-one percent of patients presented with skin complications, including aestethic alterations, infections, precancerous lesions and malignancies, which represented 57%, 43%, 18% and 9%, respectively. Risk factors were: age at transplantation ≥ 45 years, immunosuppressive therapy with cyclosporine, and phototype II and III. Our study indicates that although liver transplant recipients are at greater risk of developing skin complications compared to the general population, the risk is lower than for other solid organ transplants, particularly for premalignant and malignant lesions.

Published
2012

9. Neurologic complications after solid organ transplantation

Author

Marco, Senzolo, Senzolo, Marco, Cecilia, Ferronato, Ferronato, Cecilia, Patrizia, Burra, and Burra, Patrizia

Subjects
Immunosuppression Therapy, Heart transplantation, Transplantation, Pediatrics, medicine.medical_specialty, business.industry, Incidence, medicine.medical_treatment, Encephalopathy, Transplants, Liver transplantation, medicine.disease, Organ transplantation, Surgery, Postoperative Complications, Central Nervous System Diseases, Risk Factors, medicine, Humans, Central pontine myelinolysis, Complication, business, Stroke
Abstract

Neurologic complications are common after solid organ transplantation and are associated with significant morbidity. Approximately one-third of transplant recipients experiences neurologic alterations with incidence ranging from 10% to 59%. The complications can be divided into such of those common to all types of transplant and others of those specific to transplanted organ. The most common complication seen with all types of transplanted organ is neurotoxicity attributable to immunosuppressive drugs, followed by seizures, opportunistic central nervous system (CNS) infections, cardiovascular events, encephalopathy and de novo CNS neoplasms. Amongst immunosuppressants, calcineurin inhibitors are the main drugs involved in neurotoxicity, leading to complications which ranges from mild symptoms, such as tremors and paresthesia to severe symptoms, such as disabling pain syndrome and leukoencephalopathy. Neurologic complications of liver transplantation are more common than that of other solid organ transplants (13-47%); encephalopathy is the most common CNS complication, followed by seizures; however, central pontine myelinolysis can appear in 1-8% of the patients leading to permanent disabilities or death. In kidney transplanted patients, stroke is the most common neurologic complication, whereas cerebral infarction and bleeding are more typical after heart transplantation. Metabolic, electrolyte and infectious anomalies represent common risk factors; however, identification of specific causes and early diagnosis are still difficult, because of patient's poor clinical status and concomitant systemic and metabolic disorders, which may obscure symptoms.

Published
2009

10. Liver transplantation for hepatocellular carcinoma in clinical practice: the lesson from a 20-year multicentre experience in Italy

Author

Farinati Fabio, Giacomin Anna, Vanin Veronica, Sergio Adriana, Burra Patrizia, Cillo Umberto, Di Nolfo Annamaria, Del Poggio Paolo, Benvegnu Luisa, Zoli Marco, Borzio Franco, Giannini Edoardo, Caturelli Eugenio, Cazzagon Nora, Rapaccini Gian Ludovico, Trevisani Franco, for the Italian Liver Cancer (ITA. LI. CA) group, Andreone P, Bernardi M, Biselli M, Caraceni P, di Micoli A, Domenicali M, Magalotti D, Cappa FM, Santi V, Zambruni A, Balsamo C, Di Marco M, Vavassori E, Gilardoni L, Mattiello M, Alberti A, Gatta A, Gios M, Molaro M, Sala M, Savarino V, Risso D, Ghittoni G, Roselli P, Grazi GL, Nardo B, Ravaioli M, Pinna AD, Giampalma E, Golfieri R, Farinati Fabio, Giacomin Anna, Vanin Veronica, Sergio Adriana, Burra Patrizia, Cillo Umberto, Di Nolfo Annamaria, Del Poggio Paolo, Benvegnu Luisa, Zoli Marco, Borzio Franco, Giannini Edoardo, Caturelli Eugenio, Cazzagon Nora, Rapaccini Gian Ludovico, Trevisani Franco, for the Italian Liver Cancer (ITA.LI.CA) group [.., Andreone P, Bernardi M, Biselli M, Caraceni P, di Micoli A, Domenicali M, Magalotti D, Cappa FM, Santi V, Zambruni A, Balsamo C, Di Marco M, Vavassori E, Gilardoni L, Mattiello M, Alberti A, Gatta A, Gios M, Molaro M, Sala M, Savarino V, Risso D, Ghittoni G, Roselli P, Grazi GL, Nardo B, Ravaioli M, Pinna AD, Giampalma E, Golfieri R, and ]

Subjects
Male, medicine.medical_specialty, Carcinoma, Hepatocellular, medicine.medical_treatment, Liver transplantation, Guideline, Gastroenterology, Internal medicine, Carcinoma, Medicine, Humans, guidelines, neoplasms, Selection (genetic algorithm), Aged, Hepatology, business.industry, General surgery, HEPATOCELLULAR CARCINOMA, LIVER TRANSPLANTATION, Guidelines, Evidence-based approach, Patient Selection, Liver Neoplasms, hepatocellular carcinoma, evidence-based approach, liver transplantation, Middle Aged, medicine.disease, Prognosis, digestive system diseases, Liver Transplantation, Neoplasm Proteins, Clinical Practice, Transplantation, Treatment Outcome, Italy, Hepatocellular carcinoma, Practice Guidelines as Topic, Female, Guideline Adherence, alpha-Fetoproteins, business, Epidemiologic Methods
Abstract

INTRODUCTION: Hepatocellular carcinoma (HCC) is an established indication for liver transplantation (LT), but the selection criteria and priority are still debated. AIMS: To ascertain the number and features of patients with HCC who undergo transplantation in a Western country, the number of patients eligible for LT according to the American Association for the Study of Liver Diseases (AASLD) guidelines, the number of patients who actually undergo transplantation and whether adherence affects survival. METHODS: This is a retrospective analysis from a multicentre Italian database of 2042 cases of HCC, recruited prospectively and consecutively. Kaplan-Meier (log rank) and Cox multivariate analysis estimated survival. RESULTS: Patients who had undergone transplantation (50, 2.5%, with no change over time) had a median survival of 133 months, significantly influenced by the number of lesions and alpha-fetoprotein levels, which were found to be independent predictors of survival on multivariate analysis. Milan criteria were fulfilled in 68%, impacting on survival, whereas 48% fulfilled AASLD guidelines, without such an impact. Two hundred and twenty-eight (11%) patients were eligible for LT according to AASLD; in this group, alpha-fetoprotein levels and Child-Pugh class were independent predictors of survival. CONCLUSION: Among patients with HCC, those undergoing LT represent a small minority; even fewer (1%) are those who undergo transplantation according to AASLD guidelines, adherence to which only marginally affects survival. Overall, LT impact on HCC patients' treatment is very limited

Published
2011

11. Sorafenib use in the transplant setting

Author

Castelli, G, Burra, Patrizia, Giacomin, A, Vitale, A, Senzolo, M, Cillo, Umberto, and Farinati, Fabio

Subjects
Niacinamide, Carcinoma, Hepatocellular, Phenylurea Compounds, Liver Neoplasms, Antineoplastic Agents, Sorafenib, Neoadjuvant Therapy, Liver Transplantation, Treatment Outcome, Chemotherapy, Adjuvant, Risk Factors, Humans, Neoplasm Recurrence, Local, Immunosuppressive Agents
Abstract

Liver transplantation (LT) is an established treatment for hepatocellular carcinoma (HCC), and sorafenib (SFN) is a validated treatment for patients harboring advanced tumors. It is still not clear whether the combination of the 2 treatments, with SFN used in the neoadjuvant, adjuvant, or recurrence setting, is useful and cost-effective. This article summarizes the present evidence in favor of and against the use of SFN in the setting of LT for HCC, and it also includes the problem of toxicity, particularly when mammalian target of rapamycin inhibitors, which play a central role in regulating cellular growth and proliferation, are used as immunosuppressants. Overall, the data do not support the use of SFN in the pre- or post-LT setting as adjuvant therapy, and additional studies are needed to reach sound conclusions on the topic.

Published
2013

12. Can liver transplantation provide the statistical cure?

Author

Cucchetti, A, Vitale, A, Cescon, M, Gambato, M, Maroni, L, Ravaioli, M, Ercolani, G, Burra, Patrizia, Cillo, Umberto, Pinna, Ad, Cucchetti A, Vitale A, Cescon M, Gambato M, Maroni L, Ravaioli M, Ercolani G, Burra P, Cillo U, and Pinna AD

Subjects
Adult, Male, Models, Statistical, Time Factors, Adolescent, Graft Survival, Middle Aged, Hepatitis C, Severity of Illness Index, Liver Transplantation, End Stage Liver Disease, Survival Rate, Young Adult, Treatment Outcome, Italy, Data Interpretation, Statistical, Humans, Female, Algorithms, Aged, Probability
Abstract

Liver transplantation (LT) represents the only chance of long-term survival for patients with end-stage liver disease. When the mortality rate for transplant patients returns to the same level as that for the general population, they can be considered statistically cured. However, cure models in the setting of LT have never been applied. Data from 1371 adult patients undergoing LT for the first time between January 1999 and December 2012 at 2 Italian centers were reviewed in order to establish probabilities of being cured by LT. A parametric Weibull model was applied to compare the mortality rate after LT to the rate expected for the general population (matched by sex and age). The observed 3-, 5-, and 10-year overall survival rates after LT were 77.8%, 73.3%, and 65.6%, respectively, and they did not differ between the 2 centers (P = 0.37). The cure fraction for the entire study population was 63.4% (95% confidence interval = 52.6%-72.0%), and the time to cure was 10 years with a 90% confidence level. The best cure fraction was observed for younger recipients without hepatitis C virus (HCV) who had favorable donor-recipient matches, that is, low Donor Model for End-Stage Liver Disease (D-MELD) scores (90.1%); conversely, the lowest probability was observed for elderly HCV recipients with high D-MELD scores (34.6%). The time to cure was 6.22 years for non-HCV patients and 14.78 years for HCV patients. The median survival time for uncured patients was 2.29 years. Among uncured recipients, the longest survival time was observed for younger patients (7.31 years). In conclusion, we provide here a new clinical measure for LT suggesting that survival after transplantation can approximate that of the general population and provide a statistical cure.

Published
2013

13. Summary of candidate selection and expanded criteria for liver transplantation for hepatocellular carcinoma: a review and consensus statement

Author

Prasad, Kr, Young, R. S., Burra, Patrizia, Zheng, S, Mazzaferro, V, Moon Duk, B, and Freeman, R. B.

Subjects
Carcinoma, Hepatocellular, Evidence-Based Medicine, Treatment Outcome, Predictive Value of Tests, Patient Selection, Liver Neoplasms, Practice Guidelines as Topic, Health Status Indicators, Humans, Neoplasm Grading, Tissue Donors, Liver Transplantation, Neoplasm Staging
Published
2011

16. De Novo Tumors after Liver Transplantation: Results from a Multicentric Study, Italy 1990-2008

Author

Pierluca Piselli, Burra, Patrizia, Zanus, Giacomo, Pinna, Antonio Daniele, Lauro, Augusto, Adani, Gian Luigi, Baccarani, Umberto, Ettorre, Giuseppe Maria, Vennarecci, Giovanni, Di Leo, Alfredo, Rendina, Maria, Cimaglia, Claudia, Buda, Andrea, Gambato, Martina, Zanfi, Chiara, Di Gioia, Paolo, Santoro, Roberto, Miglioresi, Lucia, Girardi, Enrico, Puro, Vincenzo, Ippolito, Giuseppe, and Serraino, Diego

Published
2010

33. Liver transplantation: the italian experience

Author

Fagiuoli, S., Mirante, Vg, Pompili, M., Gianni, S., Leandro, G., Rapaccini, Gl, Gasbarrini, A., Naccarato, R., Pagliaro, L., Rizzetto, M., Gasbarrini, G., THE MONOTEMATICA AISF OLT STUDY GROUP, and Burra, Patrizia

Published
2002

39. The protective effects of L-arginine after liver ischaemia/reperfusion injury in a pig model

Author

Calabrese, Fiorella, Valente, Marialuisa, Pettenazzo, Elena, Ferraresso, M, Burra, Patrizia, Cadrobbi, R, Cardin, R, Bacelle, L, Parnigotto, A, and Rigotti, Paolo

Subjects
Survival Rate, Microscopy, Electron, Necrosis, Liver, Swine, Malondialdehyde, Reperfusion Injury, Animals, Apoptosis, Female, Arginine, In Situ Hybridization
Abstract

Hepatic ischaemia/reperfusion is characterized by circulatory and metabolic derangement, liver dysfunction, and tissue damage. To evaluate the role of L-arginine, a substrate of nitric oxide, in ischaemia/reperfusion injury, total liver ischaemia was induced for 120 min in 22 Landrace x Large White female pigs, which were randomly assigned to a treatment group (10 animals) or a control group (12 animals). An L-arginine bolus (540 mg/kg i.v.) was administered to the treatment group 1 h before clamping the hepatic hilum, at clamping, at reperfusion, and at 1 and 2 h after reperfusion. The control animals received normal saline and an i.v. infusion. Liver function tests and analysis of serum, erythrocyte, and tissue malondialdehyde contents were performed at commencement of laparotomy, before reperfusion, and at 30 min and 7 days after reperfusion. Liver biopsies were taken at laparotomy, at 30 min, and at 7 days after reperfusion for histological and ultrastructural examination. Assessment of apoptosis included in situ end-labelling analysis and DNA gel electrophoresis. Survival at 7 days was better in the treated animals than in the controls (9/10 vs. 7/12). Tissue malondialdehyde content, aspartate aminotransferase, and lactate dehydrogenase levels were lower in the treatment group, in which morphological changes were significantly less evident than in the controls 30 min after reperfusion. At 7 days, differences between the groups with respect to cell integrity were apparent only on ultrastructural analysis. Glycogen content, 7 days after reperfusion, was higher in the treatment group than in the controls: 70.25 per cent vs. 21.66 per cent positive hepatocytes (score 3 vs. score 1). Multiparametric analysis showed fewer apoptotic cells in the treatment group at all times. Our data show that the administration of L-arginine reduces damage to liver tissue after ischaemia/reperfusion injury in a pig model. This may be explained not only by the known vasodilator, anti-aggregation, and superoxide inactivation effects of increased nitric oxide release, but possibly also by some other action of L-arginine, such as its influence on cellular metabolism.

Published
1998

43. EASE SCORE, NOVEL ALGORITHM BASED ON KINETICS OF AST, BILIRUBIN, PLATELETS AND RECIPIENT DATA TO PREDICT EARLY ALLOGRAFT FAILURE. AN ITALIAN MULTICENTER STUDY DESIGNED IN THE PERSPECTIVE OF LIVER RE-TRANSPLANTATION WITH UK VALIDATION

Author

Franco, Antonio, Simone, Paolo, Schlegel, Andrea, Lai, Quirino, Burra, Patrizia, Patrono, Damiano, Meli, Sonia, Ravaioli, Matteo, Bassi, Domenico, Ferla, Fabio, DUILIO PAGANO, Violi, Paola, Camagni, Stefania, Dondossola, Daniele, Montalti, Roberto, Alrawashdeh, Wasfi, Vitale, Alessandro, Teofili, Luciana, Ghinolfi, Davide, Spoletini, Gabriele, Maroni, Lorenzo, Nicolotti, Nicola, Magistri, Paolo, Pastena, Dario, Bongini, Marco, Rossi, Massimo, Mazzaferro, Vincenzo, Di Benedetto, Fabrizio, Hammond, John, Vivarelli, Marco, Agnes, Salvatore, Colledan, Michele, Carraro, Amedeo, Carlis, Luciano, Cescon, Matteo, Caccamo, Lucio, Gruttadauria, Salvatore, Muiesan, Paolo, Cillo, Umberto, Romagnoli, Renato, Avolio, Alfonso, Franco, A, De Simone, P, Schlegel, A, Lai, Q, Burra, P, Patrono, D, Meli, S, Ravaioli, M, Bassi, D, Ferla, F, Pagano, D, Violi, P, Camagni, S, Dondossola, D, Montalti, R, Alrawashdeh, W, Vitale, A, Teofili, L, Ghinolfi, D, Spoletini, G, Maroni, L, Nicolotti, N, Magistri, P, Pastena, D, Bongini, M, Rossi, M, Mazzaferro, V, Di Benedetto, F, Hammond, J, Vivarelli, M, Agnes, S, Colledan, M, Carraro, A, De Carlis, L, Cescon, M, Caccamo, L, Gruttadauria, S, Muiesan, P, Cillo, U, Romagnoli, R, and Avolio, A

Subjects
LIVER RE-TRANSPLANTATION

44. FATIGUE AND NON-ALCOHOLIC FATTY LIVER DISEASE: DATA FROM THE GLOBAL NASH REGISTRY

Author

Younossi, Zobair M., Yilmaz, Yusuf, Wong, Vincent Wai-Sun, Fernandez, Marlen Ivon Castellanos, Bugianesi, Elisabetta, Burra, Patrizia, Yu, Ming-Lung, Chan, Wah Kheong, Isakov, Vasily A., Duseja, Ajay K., Mendez-Sanchez, Nahum, Eguchi, Yuichiro, George, Jacob, Fan, Jian-Gao, Papatheodoridis, George, Alswat, Khalid Aida, Hamid, Saeed S., Singal, Ashwani K., Romero-Gomez, Manuel, Gordon, Stuart C., Roberts, Stuart K., Mohamed El-Kassas, Kugelmas, Marcelo, Ong, Janus, Alqahtani, Saleh, Ziayee, Mariam, Lam, Brian P., Younossi, Issah, Racila, Andrei, Henry, Linda, and Stepanova, Maria

45. Generation and Performance of Outcome Indicators in Liver Disease: The Value Based Medicine in Hepatology Study (VBMH)

Author

Okolicsanyi, Stefano, Ciaccio, Antonio, Rota, Matteo, Gentiluomo, Maria, Gemma, Marta, Grisolia, Antonella, Scirpo, Roberto, Cortesi, Paolo A., Scalone, Luciana, Mantovani, Lorenzo G., Pecere, Silvia, Pontisso, Patrizia, Burra, Patrizia, Mario U. Mondelli, Fabris, Luca, Colledan, Michele, Fagiuoli, Stefano, Valsecchi, Maria G., Cesana, Giancarlo, Belli, Luca S., and Strazzabosco, Mario

47. HIGH MELD VERSUS HIGH DONOR AGE: LESSONS LEARNED COMPARING THE AMERICAN AND THE ITALIAN LIVER TRANSPLANT EXPERIENCES

Author

Avolio, Alfonso W., Cillo, Umberto, Agnes, Salvatore, Lirosi, Maria C., Perkins, James, Romagnoli, Renato, Cucchetti, Alessandro, Humar, Abhinav, Marco Spada, Melcher, Marc L., Caccamo, Lucio, Santaniello, Walter, Baccarani, Umberto, Ponziani, Francesca R., Burra, Patrizia, and Halldorson, Jeffrey B.

Subjects
Liver transplantation, donor age, Liver transplantation, donor age, MELD, MELD

48. Increased cancer risk in patients undergoing dialysis: A population-based cohort study in North-Eastern Italy

Author

Taborelli, Martina, Toffolutti, Federica, Del Zotto, Stefania, Clagnan, Elena, Furian, Lucrezia, Piselli, Pierluca, Citterio, Franco, Zanier, Loris, Boscutti, Giuliano, Serraino, Diego for the Italian Transplant & Cancer Cohort Study, Shalaby, Sarah, Petrara, MARIA RAFFAELLA, Burra, Patrizia, Zanus, Giacomo, Zanini, Stefano, Rigotti, Paolo, Maria, Rendina, Alfredodi, Leo, Francesco Paolo Schena, Giuseppe, Grandaliano, Marco, Fiorentino, Augusto, Lauro, Antonio Daniele Pinna, Paolodi, Gioia, Sara, Pellegrini, Chiara, Zanfi, Maria Piera Scolari, Sergio, Stefoni, Paolatodeschini, Laura, Panicali, Chiara, Valentini, Umberto, Baccarani, Andrea, Risaliti, Gian Luigi Adani, Dario, Lorenzin, Giuseppe Maria Ettorre, Giovanni, Vennarecci, Marco, Colasanti, Manuela, Coco, Fabrizio, Ettorre, Roberto, Santoro, Luciamiglioresi, Francesco, Nudo, Massimo, Rossi, Gianluca, Mennini, Luca, Toti, Giuseppetisone, Annachiara, Casella, Laura, Fazzolari, Daniele, Sforza, Giuseppe, Iaria, Carlo, Gazia, Chiara, Belardi, Claudiacimaglia, Alessandro, Agresta, Gianpiero, D’Offizi, Ubaldo Visco Comandini, Raffaella, Lionetti, Marzia, Montalbano, Chiara, Taibi, Giovanni, Fantola, Fausto, Zamboni, Gian Benedetto Piredda, Maria Benigna Michittu, Maria Gavina Murgia, Bruno, Onano, Lucia, Fratino, Luigino Dal Maso, Paolo De Paoli, Diana, Verdirosi, Emanuela, Vaccher, Francesco, Pisani, Antonio, Famulari, Federica, Delreno, Samuele, Iesari, Lindade, Luca, Maurizio, Iaria, Enzo, Capocasale, Elena, Cremaschi, Silvio, Sandrini, Francesca, Valerio, Valentina, Mazzucotelli, Nicola, Bossini, Gisella, Setti, Massimiliano, Veroux, Pierfrancesco, Veroux, Giuseppe, Giuffrida, Alessia, Giaquinta, Domenico, Zerbo, Ghilbusnach, Laura Di Leo, Maria Luisa Perrino, Marialuisa, Querques, Valerianacolombo, Maria Chiara Sghirlanzoni, Piergiorgio, Messa, Antonio, Leoni, Laura, Galatioto, Salvatore, Gruttadauria, Vito, Sparacino, Flaviacaputo, Barbara, Buscemi, Franco, Cit-terio, Gionata, Spagnoletti, Maria Paola Salerno, Evaldo Favi Giuseppe Paolo Segoloni, Luigi, Biancone, Antoniolavacca, Maria Cristina Maresca, Carmelocascone, Bice, Virgilio, Donato, Donati, Fiorella, Dossi, Andrea, Fontanella, Andrea, Ambrosini, and Marco Di Cicco

Subjects
Nephrology, Male, medicine.medical_treatment, Settore MED/18 - CHIRURGIA GENERALE, 030232 urology & nephrology, 030204 cardiovascular system & hematology, lcsh:RC870-923, Kidney Failure, Cohort Studies, Cancer risk, 0302 clinical medicine, Risk Factors, Neoplasms, Registries, Chronic, de novo malignancies, education.field_of_study, Incidence (epidemiology), End-stage kidney disease, Dialysis, Italy, Population-based study, Middle Aged, Population Surveillance, Female, Cohort study, Research Article, Adult, medicine.medical_specialty, Population, 03 medical and health sciences, Renal Dialysis, Internal medicine, medicine, Humans, education, Aged, Cancer prevention, business.industry, medicine.disease, lcsh:Diseases of the genitourinary system. Urology, Cancer registry, Settore MED/18, Follow-Up Studies, Kidney Failure, Chronic, business, Kidney disease
Abstract

Background In southern Europe, the risk of cancer in patients with end-stage kidney disease receiving dialysis has not been well quantified. The aim of this study was to assess the overall pattern of risk for de novo malignancies (DNMs) among dialysis patients in the Friuli Venezia Giulia region, north-eastern Italy. Methods A population-based cohort study among 3407 dialysis patients was conducted through a record linkage between local healthcare databases and the cancer registry (1998–2013). Person-years (PYs) were calculated from 30 days after the date of first dialysis to the date of DNM diagnosis, kidney transplant, death, last follow-up or December 31, 2013, whichever came first. The risk of DNM, as compared to the general population, was estimated using standardized incidence ratios (SIRs) and 95% confidence intervals (CIs). Results During 10,798 PYs, 357 DNMs were diagnosed in 330 dialysis patients. A higher than expected risk of 1.3-fold was found for all DNMs combined (95% CI: 1.15–1.43). The risk was particularly high in younger dialysis patients (SIR = 1.88, 95% CI: 1.42–2.45 for age 40–59 years), and it decreased with age. Moreover, significantly increased DNM risks emerged during the first 3 years since dialysis initiation, especially within the first year (SIR = 8.52, 95% CI: 6.89–10.41). Elevated excess risks were observed for kidney (SIR = 3.18; 95% CI: 2.06–4.69), skin non-melanoma (SIR = 1.81, 95% CI: 1.46–2.22), oral cavity (SIR = 2.42, 95% CI: 1.36–4.00), and Kaposi’s sarcoma (SIR = 10.29, 95% CI: 1.25–37.16). Conclusions The elevated risk for DNM herein documented suggest the need to implement a targeted approach to cancer prevention and control in dialysis patients.

49. CLINICAL PRESENTATION OF LEAN NON-ALCOHOLIC FATTY LIVER DISEASE (NAFLD) ACROSS THE WORLD: DATA FROM THE GLOBAL NASH REGISTRY

Author

Younossi, Zobair M., Yilmaz, Yusuf, Yu, Ming-Ling, Wong, Vincent, Fernandez, Marlen Castellanos, Isakov, Vasily, Duseja, Ajay, Mendez-Sanchez, Nahum, Eguchi, Yuichiro, Bugianesi, Elisabetta, Burra, Patrizia, George, Jacob, Fan, Jian Gao, Papatheodoridis, George, Chan, Wah-Kheong, Alswat, Khalid, Hamid, Saeed S., Singal, Ashwani K., Manuel Romero-Gómez, Gordon, Stuart C., Roberts, Stuart K., El Kassas, Mohammed, Kugelmas, Marcelo, Ong, Janus, Alqahtani, Saleh, Ziayee, Mariam, Lam, Brian P., Younossi, Issah M., Racila, Andrei, Henry, Linda, and Stepanova, Maria

50. HIGH MELD vs HIGH DONOR AGE in liver tx. Who is the winner ? Evidences from the US-ITALY D-MELD study

Author

Avolio, Alfonso W., Burra, Patrizia, Mariano, Germano, Chang, David, Cillo, Umberto, Cucchetti, Alessandro, Romagnoli, Renato, Humar, Abhinav, Marco Spada, Melcher, Marc L., Carlis, Luciano, Colledan, Michele, Mazzaferro, Vincenzo, Caccamo, Lucio, Lai, Quirino, Calise, Fulvio, Agnes, Salvatore, and Halldorson, Jeffrey B.

Subjects
Liver transplantation, MELD, Donor age, Liver transplantation, Donor age, MELD

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